Delore Care Surrey

Fairolive is a care agency, providing care to people living in their own homes. In total at the time of our inspection, Fairolive provided care to 58 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. Fairolive had a satellite office located in Sussex. The care provided to people in that location was managed by the main office. At the time of our inspection, 48 people received the regulated activity of personal care.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

People’s experience of using this service and what we found

Right Support:

People were encouraged with their independence and enabled to make their own decisions around their care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were provided with food appropriate for their needs and staff worked with external professionals to ensure people received health care when they needed it.

People were supported by staff who were able to recognise potential signs of abuse and knew who to report these to. Where accidents and incidents occurred, staff recorded these and appropriate action was taken to help protect people from continued harm.

Right Care:

People were cared for by staff who showed them respect and dignity. People said they had good relationships with staff and staff took time to speak with them.

People had cared plans and they were given the opportunity to be involved in them. People’s preferences were recorded and people said staff knew how they liked their care.

People were supported by staff who went through a robust recruitment process and were trained for their role.

People were cared for by staff who understood their individual risks. Where people had specific health conditions, staff were provided with guidance on how to respond to these.

Right Culture:

Although improvements had been found since our last inspection, management still had further work to do to ensure those improvements were embedded into daily practice to enable them to provide a consistently high-quality service.

People told us staff timekeeping was poor. People and relatives also said they had experienced missed calls.

There was a lack of robust delegation within the service and despite management being aware of national guidance around Right support, right care, right culture, staff had not undertaken training in learning disabilities or autism.

The stability of staffing had improved since we last visited the agency and monthly training sessions on specific topics was being rolled out by management. The agency worked with external health and social care agencies to support people’s care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement (report published 30 March 2022) and there were breaches of regulation.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made however, the provider remained in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to follow up on the shortfalls we found at our last inspection.

Enforcement

We have identified a breach of regulation in relation to good governance within the agency.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Fairolive is a care agency, providing care to people living in their own homes. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Not everyone who used the service received personal care as the agency provided care to 48 people, although only 46 received personal care. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People told us they felt improvement had been made to the service. Some people said their care call times had improved and they saw consistent staff members. We also found improvements had been made. However, there were still some short falls and further work was needed to help ensure good progress continued and the service people received was of the best quality possible.

People were kept safe by staff. Staff were aware of how to recognise potential abuse and report it. Staff knew people’s needs as they read their care plans; however, we found some detail about risks to people or their individual care needs was scant or contradictory. Other care records however were very good and provided comprehensive information to staff.

People received the medicines they required. However, recording of medicines was not always accurate and management did not carry out robust audits to assure themselves that systems were safe. In addition, where people had accidents and incidents, although these were recorded, there was little information in some cases on the action taken in response.

People may not always receive person-centred care as some people told us they remained unhappy with the timings of their visits and that staff were rushed. We found evidence of staff routinely not staying at calls for the allocated time.

Staff were recruited through a robust process and staff told us they were happy working for the service. Staff had the opportunity to meet together to discuss all aspects of their role and the service.

Compliance with the wearing of personal protective equipment had improved and the registered manager routinely checked on this when monitoring staff.

Although the service was not providing care to anyone with a learning disability, we expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was not always able to demonstrate how they would meet the underpinning principles of Right support, right care, right culture should they provide care to an autistic person or someone with a learning disability.

Right support:

Model of care and setting maximised people’s choice, control and independence;

Some people told us they did not know when care staff would be coming to them. This did not ensure they were given choice and were involved in decisions around their care.

Right care:

Care was person-centred and promoted people’s dignity, privacy and human rights;

There was a lack of consistency in the quality of people’s care plans which meant people may not always receive person-centred care. In the event the service was providing care to a person who was not able to communicate verbally, this may result in an impact to their human rights.

Right culture:

Ethos, values, attitudes and behaviours of leaders and care staff ensured people using services led confident, inclusive and empowered lives;

There was a lack of effective systems in place to help ensure that the values and culture was such that people could automatically expect a high quality, person-centred service. Improvements to the governance of the service needed to be sustained to demonstrate management and staff had the right values and attitudes.

Complaints to the service had been addressed, and we heard that people felt there was good communication between them and management. People were given the opportunity to feedback their views on the service they received.

Management worked with external agencies to help provide care to people and the registered manager had an on-going action plan in order to continue to improve the service they provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Requires Improvement (report published 30 April 2021).

Why we inspected

We carried out an announced comprehensive inspection of this service on 12 February 2021. We served a Warning Notice in relation to Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found breaches of legal requirements relating to safe care and treatment, safeguarding service users from abuse and complaints. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Responsive and Well-led which contain those requirements. We found the registered provider had met the requirements of the Warning Notice in Regulation 17 as well as the breaches of Regulation 12, Regulation 13 and Regulation 16. However, we found a continued breach of Regulation 17.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed following this focused inspection and remains as Requires Improvement. This is based on the findings at this inspection.

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fairolive on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Fairolive is a domiciliary care agency providing personal care to people living in their own homes. Some people receiving the care may be living with dementia, a physical condition or a health condition.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, the agency was providing care to 75 people.

People’s experience of using this service and what we found

People told us staff failed to arrive on time and did not stay the full time expected. We also heard from people that they had experienced missed calls. Some people said staff did not treat them with respect or care.

Although staff could tell us what to do if they suspected abuse, they failed to keep people safe due to their timekeeping, missed visits, lack of information about risks to people and poor infection control practices. People said staff did not always wear masks or gloves.

There was a lack of support plans for people and despite being told documentation would be in place shortly after someone commenced with the agency, we found this not to be the case. Although the registered manager responded to these shortfalls following our inspection, their own systems audits had failed to highlight the shortfalls we found.

People said they would not know who to raise a complaint or concern with and felt any feedback they gave on the care they received was not listened to. We found a lack of records for complaints received meaning the registered manager could not review information for themes or trends.

People told us they felt staff were competent and where people required the input of a healthcare professional they were supported in this respect. However, we identified some shortfalls in staff practice. Some people told us they were happy with their care worker and that they provided the care they needed. We read compliments received by the agency in relation to people’s care.

Staff received supervision and support from management and were happy working for the agency. In turn, management valued their staff and looked for ways to improve the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 09/06/2018 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about people not receiving appropriate care, staff not staying the full amount of time that people expected or being unwilling to carry out personal care tasks. We had been told staff did not follow good infection control processes, medicine practices were not good and records falsified. We were also told there was a lack of management oversight of the service and a response to complaints. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the five key question sections of this full report. You can see what action we have asked the provider to take at the end of this full report. We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.